Provider Demographics
NPI:1518330687
Name:SEIFERT, ERICA (PA-C)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SEIFERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11800 EDGEWATER DR
Mailing Address - Street 2:APT #1011
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1777
Mailing Address - Country:US
Mailing Address - Phone:412-849-9229
Mailing Address - Fax:
Practice Address - Street 1:9105 CEDAR AVE
Practice Address - Street 2:E BUILDING
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004513363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1518330687Medicaid